A critical assessment of the prognostic value of clear cell, papillary and chromophobe histological subtypes in renal cell carcinoma: A population-based study

Umberto Capitanio, Vincent Cloutier, Laurent Zini, Hendrik Isbarn, Claudio Jeldres, Shahrokh F. Shariat, Paul Perrotte, Elie Antebi, Jean Jacques Patard, Francesco Montorsi, Pierre I. Karakiewicz

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To assess the magnitude of the effect of histological subtype (HS, the three most common being clear cell, papillary and chromophobe) on cause-specific mortality (CSM) from renal cell carcinoma (RCC). Patients and Methods Univariable and multivariable Cox regression models included data from 11 618 patients treated with nephrectomy between 1988 and 2004 in nine Surveillance Epidemiology and End Results registries. We tested whether HS represents an independent predictor of CSM, and whether HS adds to the ability of other variables to predict CSM. The covariates comprised age, year of surgery, T stage, nodal status, M stage and Fuhrman grade. Results In a multivariable model predicting CSM, HS was an independent predictor (P = 0.03), but failed to improve the accuracy of the model (+0.1% gain when HS was included in the model). Conclusion Although we confirmed that HS is an independent predictor for CSM, there was no gain in accuracy when HS was added to standard predictors of CSM. From a practical perspective, this implies that patients with clear cell, papillary and chromophobe HS share similar natural histories after nephrectomy, provided that other cancer characteristics are accounted for. From a statistical perspective, in multivariable models of CSM, the clear cell, papillary and chromophobe HS might be included as a single entity.

Original languageEnglish
Pages (from-to)1496-1500
Number of pages5
JournalBJU International
Volume103
Issue number11
DOIs
Publication statusPublished - Jun 2009

Keywords

  • Cause-specific mortality
  • Chromophobe
  • Clear cell
  • Histological subtypes
  • Papillary
  • Renal cell carcinoma

ASJC Scopus subject areas

  • Urology

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